giving polluters a pass. wants why sarah palin ernst in washington. joni ernst. promises to them. too extreme for us. league of voters is responsible for this advertising. >> i get very upset. are you ready to apologize? >> you're damn right! >> that individual had no college education. ironic that there's this big push to shut down the house. any advanceve degrees in economics? there's hardly anybody working there. >> there's no towel service. >> a farmer from iowa. school.r went to law >> we're doing our own laundry down there. master's or have a ph.d. in health care policy. >> one of the most important gym.s i go is to the house >> have you published any scholarly treatises in a

peer-reviewed journal? >> he never went to law school. apologize?ready to >> you're damn right! >> i get very upset. >> on friday, our campaign 2014 coverage continues, with the governor's debate. chases mary burke. at 8:00 p.m. eastern, here on c-span. c-span's campaign 2014 coverage than 100 debates for the control of congress. stay in touch by following on twitter @cspan. coming up, the house energy and

commerce committee examining the u.s. response to the ebola outbreak. later, another chance to debate iowa senate between democratic congressman bruce braley and republican candidate joni ernst. >> c-span's 2015 student cam competition is under way. this nationwide competition for middle and high school students will award 150 prizes totaling $100,000. create a five-minute to documentary on the topic, the three branches and you. varyingeed to show points of view and must be submitted by january 20, 2015. to studentcam.org for more information. startedamera and get today! >> on the next washington policy, the bipartisan center discusses new ebola screening procedures at

airports. u.s. andok at international efforts to fight isis, with retired lieutenant colonel john nogle. calls, facebook comments and tweets, all on washington journal, live every eastern on7:00 a.m. c-span. >> here are just a few of the comments we recently received from our viewers. in reference to this ebola thing. i'm watching it, some u.n. thing going on. resort inmultimillion cuba. guantanamo. called the teams from west africa, heading to united states. i don't think a couple minutes make sureamo to they're healthy an -- healthy trip. to finish their >> i don't believe a thing that this government tells us

about ebola. fdaan't trust our inspectors here now, as it is, and the federal government wants to believe them on ebola? ha! kidding me! to be is the ebola outbreak following the lines of disease, genocide.hing, now the world is concerned, because the chickens are coming home to roost. your guest here talked about the monkey meat. you know, the people in africa are starving. i have a friend that's well-traveled. she went to the congo three years ago. it hasn't changed much. just worriedare about how to live from day to day. >> and continue to let us know what you think about the programs you're watching. call us at 202-626-3400. us at comments@cspan.org. or you can send us a tweet.

a house energy and commerce hearing on the u.s. the ebola outbreak. members heard testimony from cdc frieden and national institute of allergy and infectious diseases fouchi., anthony three hours. >> good afternoon. i convene this hearing of the oversightee of investigation. >> chairman, i can't see the witness. sure will need to make that the media is -- when the we arees are speaking, clear of the center section. today, the world is fighting the ebola epidemic in history. cdc and our public health system of a fire.middle job 1 is to put that out

completely. we will not stop until we do. we must be clear-eyed and to protect purpose public health and to ensure not one additional case is contracted here in the united states. we in congress stand ready to serve as a strong and solid this crisis,lving because there is no greater responsibility for the u.s. government than to protect and defend the safety of the american people. in this battle couldn't be any higher. cases inr of ebola west africa is doubling about every three weeks. the math still favors the virus, the recent surge in global response. with no vaccine or cure, we are facing a disease for which there is no room for error. we cannot afford to look back at point in history and say we should have done more. errors in judgment have been and it is ourre, immediate responsibility to learn from those errors, correct rapidly, and move forward effectively as one team, one fight. stand.review where we

when the latest ebola outbreak in west africa was confirmed months ago, authorities thought it would be similar to the 1976 outbreaks and quickly contained. wrong.rned out to be by underestimating both the -- the danger, dame mistakes have been made. adequate practice for the past has proven to fall the presence. the trust and credibility are waning as the american public loses confidence each day. restored.rust must be but it will only be restored with honest and thorough action. we have been told, quote, virtually any hospital in the isolationat can do isolate can do isolation for ebola. the events in dallas prove otherwise. current protocols were not sufficient. false assumptions create real mistakes, sometimes deadly mistakes. we must understand what went

firm so we can get a handle on this crisis. ay was the cdc slow to deploy rapid response team at texas health presbyterian hospital? why weren't protocols to protect health care and hospital workers rapidly communicated? what training have health care workers received? and there are things about ebola we don't know. virus live onthe surfaces? how do health care workers wearing protective gear get infected? and n.i.h. tell us that ebola patients are only contagious when having a fever. ofever, the largest study the current outbreak found that nearly 13% of confirmed cases if not haveca did associated fever. now, i respect the cdc as the public health.or but the need for strong congressional oversight and remains paramount. i want to understand why cdc and changed course on proposals first introduced in that would have

strengthened the federal quarantine authorities. my ongoing concern that administrative officials still refuse to consider any for the morections than 1,000 travelers entering the united states each week from zones.ot a month ago, the president told us someone with ebola reaching thathores is unlikely and we've taken the necessary precautions to increase screening in airports so that notone with the virus does get on a plane to the united states. screening and self-reporting in arports have been demonstrated failure, yet the administration continues to its contradictory doesn't make sense. it troubles me even more when public health policies are based stated concern over cutting commercial ties with ratherng democracies than protecting public health in the united states. this should not be presented as nothing choice. we can and will create the means to transport whatever supplies

and goods are needed in africa to win this deadly battle. we do not have to leave the door to all travel to and from hot zones, while ebola is an and dangerous stowaway on these flights. i am confident we can develop a to meetul strategy these needs. the current airline passenger screening at five u.s. airports through temperature taking and self-reporting is troubling. tell --d and n.i.h. both cdc and n.i.h. tell us that ebola patients are only have aous when they fever. totallynow this is not accurate. further, it is nearly impossible to perform contact tracing of multiplee on international flights across the globe. let me be clear to all the agencies responding to the outbreak. if resources or authorization is needed to stop ebola in its us in congress. i pledge, and i believe this in pledging,ns me that we will do everything in our power to keep the american

ebola safe from the outbreak in west africa. i now recognize the ranking member of the committee. you, mr. chairman. on monday, the director general of the world health organization called the ebola outbreak, quote, the most severe acute seen in moderny times. she warned that the epidemic, very, threatens the survival of societies and governments in west africa. this w.h.o. assessment is no exaggeration. 1.4predicts that up to million west africans could be infected with ebola. many more will die from treatable illnesses due to the countries' these public health infrastructure. a humanitarian crisis. the outbreak is also a u.s. national security imperative, because doing so is way to keep ebola out of the united states. i was alarmed, like all a of us

were, when thomas duncan flew to the u.s. while harboring ebola more disturbed to learn of his discharge from the texas fever after with a reporting that he had traveled from liberia. even worse, we learned this week two nurses tweeting mr. duncan, nina pham and amber vinson, have contracted ebola. i know, mr. chairman, we all join in sending these women and families our prayers. these new cases raise serious questions. the washington post wrote that texas presbyterian, quote, had to learn on the fly how to control virus.dly and that the hospital was, quote, not fully prepared for ebola. need to find out why this hospital was unprepared and if others are too. need to make sure that the cdc is filling these readiness gaps. we should be concerned about the appearance of ebola in the u.s. transmission to health care workers. but we should not panic. ebolaw how to stop

outbreaks by isolating patients and tracing and monitoring contacts. the u.s. health care system can prevent isolated cases from outbreaks.oader and that's why i'm glad dr. frieden is here with us. and dr. varga will be with us by video. an understatement to say that the response to the patient withsed ebola has been mismanaged, scores ofsk to additional people. i know both of these gentlemen will be transparent and helping me to understand how we can improve yet another when person, and it will inevitably theen, shows up at emergency room with these kinds of symptoms. i appreciate the steps taken by customs to begin airport screenings. these steps are appropriate. call for cutting off all travel, as the chairman said, this won't be reasonable

to stop anybody with ebola from coming into the united states. steps don't want to take that would endanger americans by haltfering with efforts to the outbreak in africa. you know, there's no such thing as fortress america when it comes to infectious diseases. and the best way to stop ebola be to stop this virus in africa. experts from doctors without have told us that a quarantine on travel would have quote, catastrophic impacts on west africa. also, earlier this week, the director of n.i.h., dr. collins, said had we adequately funded his agency for over a decade, we ebolaalready have an vaccine. his words are a reminder that key public health agencies have stringent -- stagnant funding for several years, hampering our ability to respond crisis. mr. chairman, six weeks ago, when i first sent you a letter

to ask for this hearing, the scope of the problem in west africa was beginning to come into focus. now the situation is dire. did let's work together to make sure that we stop it as quickly as we can. with that, i field the balance of my time to the gentleman from iowa, mr. braley. >> thank you. our duty today is to make sure the administration is doing everything possible to prevent the spread of ebola within the united states. our number 1 priority in combating this disease must be protection of americans, and we have to figure out the best way to do that. thosert goes out to all suffering from this horrible epidemic. the hardery proud of work done by american troops, doctors, nurses and other thisteers to combat disease. congress must come together, put aside partisan differences and help stop this outbreak. today i hope to hear what steps the administration is taking to the spread of ebola and respond to the outbreak. i'm greatly concerned, as

congresswoman has expressed, that the administration did not responding inh in texas. we need to look at all the options available to keep our and move quickly and responsibly to make any at airports --es >> time has expired. >> okay. >> we have a lot to do here, so we'll just keep going. >> okay. you. >> thank you. we now recognize chairman of the mr. upton, for five minutes. >> let me first begin by witnesses and all members, republicans and democrats, for being here today. unusual to convene a hearing in d.c. during this but there is no time to wait. i was glad to see the president campaign trail yesterday to focus on the crisis. people are scared. we need all hands on deck. we need a strategy. and we need to protect the

american people, first and foremost. it's not a drill. people's lives are at stake and beenesponse so far has unacceptable. as chairman of this committee, i want to assure the witnesses stand ready to support you in any way to keep americans safe. but we're going to hold your the fire on getting the job done. and in getting it done right. the globals. and health community have so far failed to put in place an effective strategy fast enough to combat the communit current . cdc admitted more could have been done in texas. two health care workers have with ebola, even as nurses and other medical suggest that protocols are being developed on the fly. and none of us can understand an a nurse, who treated ebola-infected patient and who had herself developed a fever permitted to board a commercial airline and fly across the country. public'sonder that the confidence is shaken. over a month before, before wela reached our shores,

wrote secretary burwell seeking details for the preparedness and at home andn here abroad. it's clear whatever plan was in place was insufficient. believe we can and must do better now. we need a plan to treat those train health to care workers to safely provide care and to stop the spread of home and at here at its shores in africa. this includes travel or bans from that region, beginning today. surely we can find other ways to the aid workers and supplies into these countries, and from to terrorists watch lists quarantines, there are tools used to manage air travel to assure public safety. why not here? we can no longer be reacting to each day's crisis. we need to be aggressive and finally get ahead of this terrible outbreak. the american people also want to troops andour medical personnel who are courageously headed to africa to sick.the how are they going to be protected?

carent to know that health workers have the training and resources to safely combat that threat as well. not just the responsibility of the u.s. the global health community charge to develop a clear strategy and train all of involved in combating this disease and eradicate the threat. we have all heard the warnings to get worsegoing before it gets better. people are scared. it is our responsibility to government ise doing whatever it can to keep the public safe. diana and i have partnered together to help improve the research and speed, the approval of lifesaving medicines and muchment and while attention has been paid on how this can help with diseases like these samediabetes, reforms have to help us in the development of treatments for infections like ebola. we are partners in these efforts to save lives. the balance of my time to dr. burgess. >> thank you.

mustnk everyone agrees we fix this. america's reonse to the ebola virus disease outbreak is not a issue.al it's a public health crisis and a very dire one at that. truth is weing cannot guarantee the safety of our health care workers on the front lines. it has been known for some time that health care workers have an risk in western africa. 56% of -- they have a 56% rate of those health care workers who catch this disease. contracted ebola in the united states. and indeed, we have to learn inm the current situation texas and use any information we can gather to better help and protectitals our health care workers on the front line. we are here today because we to these questions. this past august, the inspector general of the department of homeland security anti-viralport on countermeasures. they found that the department

of security did not adequately a needs assessment prior to purchasing supplies and then did not effectively manage its stockpile of personal protective equipment and anti-viral medical countermeasures. this just illustrates how unprepared we are. we have to get this right. yield theke to balance of my time to ms. blackburn from tennessee. thank you, dr. burgess. yes, indeed, welcome to all of witnesses. everyone has mentioned we're here to work with you to protect americans. that includes the caregivers. by that, i mean the men and frontworking on the lines, the screaming eagles of from fort campbell. thank you. >> yields back but the time has expired. i would now like to introduce -- i'm sorry. go to you. >> thank you, mr. chairman. i'm pleased to have this opportunity to make an opening before we hear from the witnesses. ofhink we have to put all

this in perspective and not panic. everybody said not panic. statementsey made like we're going to get tough, we're going to do something about it. what do we need to do? first of all, we've got a problem in africa. serious outbreak that could spiral beyond our control. the world health organization estimated that soon there could be up to 10,000 new cases each week in west africa. thethe cdc has warned that outbreak could infect as many as people by the end of january. a humanitarian crisis in africa. and we have a responsibility to help, because if we don't help tore, that outbreak is going continue to spiral out to other places. sealing people off in africa is not going to keep them from

traveling. asy'll travel to brussels one of the people did and then into the united states. epidemic frome spreading in africa or the isolate thes if we and monitor the contacts of that patient. that, we can stop it there, and we can stop it here. need to know,we are we moving fast enough? responders have adequate resources? are we effectively coordinating our response with other countries and international organizations? but here, people are scared. and we should make them even frightened. put this in perspective. we've had three recent cases of in this country. thomas duncan, who entered the ebola, andharboring who flew through brussels to get here. the pham and amber vinson, nurses who became ill while caring for mr. duncan.

concerned about these cases, and we need to act urgently. not panic. what we have to do is learn what we need to do, what mistakes we have made. and not repeat them. we want to find out what texas health presbyterian hospital, how cdc, local health officials and hospitals can improve procedures moving forward. a should also use this as wake-up call to ensure the publicy of our own health and preparedness safety net. prepared before a crisis hits, not scrambling to respond after the crisis. in the past decade, the ability public research and health programs has declined here in the united states. since 2006, cdc's budget adjusted for inflation has dropped by 12%. funding for the public health

emergency preparedness cooperative agreement, which supports state and local health preparedness activities, has been cut from $1 billion in its first year of funding in 2002 to $612 million 2014. all of these were also subject sequestration. and those who allowed that sequestration to happen by the government have to answer to the american people as well. adequateo commit funding to public health infrastructure. we need to hold public health accountable to standards of preparedness. know, itwhat we appeared that texas presbyterian would have not met those standards. though, in fairness, i suspect that many, many hospitals all also haveountry would struggled to respond. this is a problem we have to solve. mr. chairman, before i run out of time, i want to acknowledge the health care workers and

volunteers, those treating ebola victims in the u.s. and those to west africaed to help during this outbreak. it's a dangerous work they're doing. themselves ing danger to save lives. they deserve our thanks and our praise. want to thank all of our witnesses. iu have my confidence and appreciate you joining us today to provide answers about how to ebola outbreakt in africa and how to improve our public health systems to avoid the next crisis. i am ending my career at the end beenis year, but i've hearings where, when there's a crisis, we have fingers.nting let's point fingers at all of those responsible. have noa, they infrastructure. we have to help them develop it crisis, but weis shouldn't leave ourselves vulnerable by these irrational

budget cuts. you.ank i would now like to introduce the witnesses on the panel for hearing. dr. thomas frieden is the director of the centers for prevention.rol and fauchi is within the institutes of health. dr. luciana borio is the thestant commissioner at u.s. food and drug administration. mr. john p. wagner is the acting of thent commissioner office of field operations within u.s. customs and border protection at the u.s. security. of homeland and joining us today in video conference from texas will be varga, a chief clinical officer at the texas health resources. he'll be joining us in a moment.

swear in the witnesses. you are all aware that the committee is holding an investigative hearing, and when doing so, has had the practice of taking testimony under oath. of you have any objections taking testimony under oath? no.the witnesses say and dr. varga? >> no. >> thank you. chair then advises you that under the rules of the house and the rules of the committee, you entitled to be advised by council. do any of you desire to be by counsel during your testimony today? okay. everyone answers no. case, would you all please rise and raise your right hands? you in.wear do you ware the testimony you are about to give is the truth, truth and nothing but the truth? thank you, doctor. you are now under oath and subject to the penalties set section 18, title 18,

of the united states code. you each to give a five-minute opening summary of your written statement. dr. frieden, you're recognized for five minutes. >> thank you very much, chairman ranking member, chairman members.ng i very much appreciate the opportunity to come before you epidemics the ebola and our response to it, to protect americans. dr. tom frieden. i'm trained as a physician. i'm trained in internal infectiousn diseases. i completed the cdc epidemic intelligence service training and i've worked in the control diseases, communicable diseases and others, since 1990. ebola spreads only by direct contact with a patient who is the disease or has died from it or with their body fluids. ebola is not new, although it is new to the u.s.

know how to control ebola, even inthis period, lagos, nigeria, we've been able outbreak. the we do that by tried and true measures of finding the patient's promptly, isolating them effectively, identifying contacts, and ensuring that if any contact becomes ill, rapidly identified, isolated and their contacts are identified. shortcuts in no shortcuttings the control of ebola. and it is not easy to control it. the united states, we source.stop it at the there is a lot of fear of ebola. you, as theell director of cdc, one of the ebola isfear about that it could spread more widely in africa.

it couldere to happen, become a threat to our health wetem and the health care come.or a long time to our top priority, our focus, is 24/7 to protect americans. that's our mission. fromotect americans threats. in the case of ebola, we do that levels.tem at multiple in addition to our efforts to control the disease at the source, we have helped each of countries establish exit screening so that every their leaving has temperature taken. in the two-month period of august and september, we identified 74 people with fever. none of them entered the airport or boarded the plane. we know, none of them were diagnosed with ebola but that was one level of safety. recently, we have added another level of screening people on

arrival to the u.s. that identifies anyone with fever here. we've worked very closely with the department of homeland the customs and border protection to implement that program. and i would be happy to provide of it later.ls we've also increased awareness theg physicians throughout u.s. to think ebola in anyone fever and/or other symptoms of infection, and who africa in thest previous 21 days. we've established laboratory the countryoughout so that not all laboratory tests have to come to the specialized laboratory at cdc. in fact, one of those in austin, texas, identified the first case here. we also have fielded calls from publiced doctors and health officials throughout the country. 300 calls andthan

only one patient, mr. duncan, had ebola. but that's one too many. and we're open to ideas for what keep americans as safe as possible, as long as the outbreak is continuing. established emergency response teams from go within hours to any hospital that has an ebola case to he them provide effective care safely. lot of understandable concern about the cases in dallas. have one slide, if we can show it, of the contact tracing activities there. think we provided copies for the members. the two core activities in dallas are to ensure that effective infection control and to trace contacts. timeline of a exactly what has happened and the identification of contacts.

we have followed each of the contacts. or if anyecome ill become ill, we immediately isolate them so that we can chain of transmission. that's how you stop ebola. i can go through the details when you wish. we also are working to ensure that there's effective infection control there. can go through the details of that. tosum, cdc works 24/7 protect americans. there are no shortcuts. do their part. there are more than 5,000 hospitals in this country. 2,500 healthe than departments at the local level. we're there to support. world-classwith expertise. and we're there to respond to helpts so that we can protect americans. and we're always open to new ideas. open to data, because our bottom line is using the most accurate data and inform our to actions and protect health. thank you.

>> thank you, dr. frieden. you, chairman murphy, ranking members. about thet heard public health aspects of ebola virus disease from dr. frieden. opportunity toe speak with you this morning for thew minutes on the role of national institute of allergy and infectious diseases in research addressing ebola virus disease. that our activities actually started with the tragic of 9/11/2001, which were the anthraxsely by attacks which many of the members remember, against the congress of the united states and the press. it is in that environment that a approach towards bioterrorism was mounted by the government. we soon became very aware that outbreaks ofurring disease are just as much of a

world to the american and public as deliberate bioterror. you see on the slide a number of category al pathogens, from anthrax, small pox. at the last bullet, the hemorrhagic fevers, including ebola an others. areviral hemorrhagic fevers particularly difficult, because they have a high degree of lethality. therapy is mainly supported without specific interventions vaccine. not have a what is the role of the national institutes of health? slide.ould advance the the role of the national institutes of health, in the endeavor, as you can see on the slide we do basic and clinical research. importantly, we apply and supply resources for researchers academia toand answer product development. do are game of what we

diagnostics, therapeutics and vaccines. i'm sorry. could we get the slide back on the -- the last slide? no. the previous one. i'm very sorry. could we get it back? there. right there. this is a multiinstitutional endeavor. see on the slide, the n.i.h. is responsible for fundamental basic research and early concept development. something that we did relatively alone, because of the lack of the industrial partners of making interventions. partnered with dr. robinson withhen we partnered industry, as we've done in a moment, as i'll tell you, to ultimately, in collaboration fda, to get the approval of products. next slide. you've heard a lot about therapeutic interventions. i'd just like to spend a moment talking to you about a few of them. first, it's important to realize

experimental.all none of them have proven to be effective. so when you hear about giving a a positive effect, a,do not know at this point, is it a positive effect? or b, is it causing harm? and that's the reason why we need to study these carefully at the same time we rapidly can make them available for the people who need them. the first one on the list is zmapp. you've heard of it. was given to dr. brantley. it looks very good in animal models. it still needs to be proven in the human. there are others, such as the pharmaceuticals product. you've heard about the tekmira developed by -- in support by the depth of defense, and that you'll hear about. these are just a few of those, that will be going into clinical trials and that are used, and with certainsionate use in

individuals. let me turn to this slide here, which is an important one. vaccine.arding a we have been working on an ebola number of years. we did the original studies shown in an animal model to be quite favorable. are now right at the phase, in phase 1 trials that some of you may have heard of. at the n.i.h. on september 2. a second vaccine was started just a couple of days ago by the military in collaboration with the n.i.h. when we finished those phase 1 namely asking, is it safe? and does it induce a response would predict would be protective? it's important to make sure it's safe. parameters are met, we will advance to a much larger trial in larger numbers of individuals to determine if it welltually effective, as paradoxicalg a deleterious effect. if we do not control the

with pure public health measures, it is entirely conceivable that we may need a vaccine and it's important to prove that it is safe and effective. making ano close by announcement. this evening tonight we will be admitting to the clinical specialunit, the clinical studies unit at the national institutes of health known as, otherwise nurse number 1. she will be coming to the national institutes of health we will be supplying her with a state of the art care in containmentel facility. thank you very much, mr. chairman. >> thank you. recognize dr. robinson for five minutes. >> good afternoon, chairman upton, rankingn members and other distinguished members. tonk you for the opportunity speak with you today about our efforts by the government on ebola. dr. robinson. a former vaccine developer in the industry.

a publicast ten years, servant working on pandemic preparedness and many other biothreats. the government agency responsible for supporting advanced development and of innovative medical countermeasures, such as vaccines, and medical devices for the entire nation. thea exists to address medical consequences of biothreats. supported medical developments on a routine basis and responded to emerging threats like h1n1, pandemic in avian influenza. today we are immersed in isponding to ebola, which simultaneously a biothreat with a material threat determination. and an emerging infectious disease. as you have said, and my colleagues have said, when it comes to ebola as a biothreat, the best way to protect our

is to address the current epidemic in africa, the worst on record. with its federal partners to transition the medical countermeasures from to advanceopment and development towards ultimate fda approval. have built an advanced development pipeline of more than 150 medical countermeasures for chemical, nuclear threats and pandemic influenza. have of these products been fda approved in the last two years. today we are transitioning and maturingsing ebola vaccines and therapeutic candidates from early development under n.i.h. and d.o.d. support, in ensuring that commercial scale manufacturing capacity for these product candidates is available soon as possible. barta, in concert with our ensures thaters, we have countermeasures to protect our citizens. bartahe past five years, with n.i.h., cdc and fda, and

our industry partners, have flexible and rapid responsive infrastructure to manufacture medical countermeasures. pandemic, and the the preparedness authorization act, an approved framework has federal andd to industry partners. last year, we made five new record candidates in time for the outbreaks in china. currently, we're working with a of partners, including both small and large pharmaceutical companies, the u.k., the world health organization, and others and evaluate the safety ebolaficacies of these candidates. -- we assist product developers on a daily basis to respond immediately in a public health emergency. we're using a number of our our centersrograms, for innovation and our

to makeuring network these products available as soon as possible. are onnally, our staff site at the manufactures. people on plant to provide technical assistance to expedite product availability. additionally, we're working with others internationally with our modeling efforts to outbreak as itla becomes an epidemic and also what possible impacts, may occur.ns barta supports large-scale medicalon of countermeasures, for public the h1n1ergencies like pandemic. today we are assisting ebola vaccine and therapeutic manufacturers with scaled-up production. specifically we're supporting the development and zmapp, one ofof the antibody therapies. expanding overall manufacturing capacity of zmapp by enlisting manufacturers.er and working on alternative

candidates to expand production capacity. pending the outcome of ongoing barta isudies, prepared to support additional treat ebolato patients. on the vaccine front, barta is partnersith industry to scale up manufacturing of three promising ebola vaccine of which we will make an announcement today, from pilot scale to commercial scale. addition to barta's efforts in the ebola response, we're supporting a number of other responses, supporting the of deployingpect u.s. public health service officers to west africa and coordination and communication with national and international communications responding to the threat. finally, we face significant challenges, as have been discussed, with the ebola epidemic continuing.

bottom line is that my colleagues here and our industry ourners will use all of collective capabilities here and abroad to address today's ebola and to be better prepared for future ebola outbreaks and bioterrorism forwards.ng i want to thank you for your continued support and the opportunity to testify. thank you. >> thank you. >> good afternoon, chairman maneuver. murphyternoon, chairman and members of the subcommittee. thank you for the opportunity to appear before you today to discuss the fda's actions in response to the ebola epidemic. tragic global event. my colleagues and i at the fda are determined to do all we can to help end it as quickly as possible. for safe andd need effective vaccines and treatments is overwhelming. extraordinaryken steps to be proactive and flexible. we're leveraging our authorities

and working diligently to expedite the development, ofufacture and availability safe and effective medical products for ebola. uniqueroviding the fda's scientific and regulatory advice to companies to guide their submissions. reviewing data as it is received. thee actions help advance development of investigational products as quickly as possible. case of themple, in two vaccines that were mentioned, the fda took only a days to review the applications and to allow the studies to proceed. the vaccine codevelopeding began phase 1 clinical testing othertember 2 and the vaccine candidate began similar 13.ing on october we're also partnering with agencies that support medical development, including the department of defense. because of the fda's long

with thecollaboration d.o.d., the fda was able to ebolaize the use of the diagnostic test under our emergency authorization within request.of the we authorized the use of two additional diagnostic tests and theseby the cdc tests, of course, are essential for an effective public health response. we're supporting the world health organization. our scientists are providing technical advice to the w.h.o. to assess the role of plasma in treating patients with ebola. recently participated in a meeting in geneva which included dozens of experts from around well as from affected and neighboring countries in west africa. participants agreed that promising investigation of incines must be evaluated the most urgent manner. the fda is working closely with colleagues and the vaccine developers to support this goal.

though,portant to note, that while we all want access to orediate therapies to cure prevent ebola, the scientific fact is that these investigational products are in the earliest stages of development. there is tremendous hope that products will help patients. but it is also possible that hurt patients and others may have little or no effect. therefore, access to investigational products should trials whenlinical possible. they allow us to learn about anduct safety and efficacy they can provide an equitable means for access. fda is working with our colleagues to develop an innovative clinical trial companies andlow clinicians to evaluate multiple investigational ebola products a common protocol. the goal is to ensure accrual of interpretable data and generate actionable results in the most expedition manner.

for the global community to know the risks and benefits of these products as possible. until such trials are toomplished, we'll continue enable access to these products when available and requested by clinicians. have mechanisms, such as compassionate use, which allow access to investigational outside of clinical trials when we assess that the outweigh thefits potential risks for the patient. i can tell you that every ebola patient in the u.s. has been treated with at least one investigational product. the fda -- because ebola rapidlya serious and fatal disease, the fda has approved such requests within a matter of a few hours and oftentimes in less than one hour. there are more than 250 fda staff involved in this response. and without intention, everyone has been proactive, thoughtful and adaptive to the complex range of issues that have

emerged. committed to sustaining our deep engagement and aggressive activity to robust response to the ebola epidemic. thank you. and i'll take your questions later. >> thank you. mr. wagner, you're recognized for five minutes. andhank you, chairman distinguished members of the subcommittee for the opportunity efforts of u.s. customs and border protection. each day, about one million travelers arrive in the united states. about 280,000 arrive at our international airports. cbp is responsible for securing our nation's borders while facilitying the flow of legitimate and international trade so vital to our nation's economy. this broad responsibility, our mission remains to prevent terrorists united states.he however, we also play an limiting thee in introduction of diseases from foreign countries. 100e had this role for over years. we've had modern protocols in

place that have guided response to a variety of significant health threats. officers assess each traffer illness. signs of cbp, in close collaboration with cdc, is working to ensure that officers are provided the information, training and equipment needed to identify and respond to international travelers who may pose a threat to public health. all officers are provided training on identifying and addressing travelers with any potential communicableuding diseases such as ebola. cbp officer training includes which health training teaches officers to identify, through visual observation and questioning, the overt symptoms and characteristics of ill travelers. cbp also provides operational to respond tow travelers with potential illness, including referring individuals who display signs of illness to cbp quarantine well as as implementation of its isolation and quarantine protocols.

provideslly, cbp training for its front line personnel by covering key blood-bornecbp's pathogens exposure control plan, personal protective equipment, other preventive measures and procedures to follow in a potential exposure incident. we're committed to ensuring our personnel have the most accurate virusation regarding this since the outbreak began. cbp field personnel have been steady stream of guidance, starting with initial information, with numerous and updates since then. information sharing is critical and cbp continues top engage with -- to engage with health and medical authorities. a liaisonationed requestso facilitate for information. starting october 1, cbp began providing ebola information to travelers entering the united states from guinea,

leone. and sierra this provides the traveler information and instructions should he or she have a concern possible infection. in addition to visually screening all passengers for startingns of illness, and cdc began cbp enhanced screening. and today we expanded these enhanced efforts at dulles, chicago o'hare, atlanta and newark. travelersely 94% of from the affected countries enter the united states through these five airports. targeted travelers are asked to complete a cdc contactnaire, provide information and have their temperature checked. based on these enhanced screening efforts the officers will make a public health assessment. measures additional went into effect, cbp has conducted enhanced screening, on travelers known to have traveled these threeof affected countries. additionally, 13 travelers were additionalas needing

screening during the course of our standard interview process that's applied at all ports of entry. a total of eight have been sent to tertiary screening by cdc. note that sot to far, all passengers were examined and released. officers receive training in illness recognition and response, if they identify an individual believed to be cbp will isolate the traveler from the public in a asignated area and contact local quarantine officer along healthcal public authorities. to officers are trained infection-control when they encounter individuals with overt illness.of personnelsary, cbp will take the appropriate safety measures based on the level of potential exposure. these procedures, designed to minimize risk to our officers have been public, utilized by both agencies on a o -- a number of

occasions with positive results. cbp will continue to provide and guide guidance, work closely with our partners of ebola in spread the united states. thank you for the opportunity to testify today. and the attention you're giving to this very important issue. i'll be happy to answer any of your questions. going to recognize the chief clinical officer on videos from texas conference. dr. varga. >> good afternoon, chairman murphy, vice chair burgess and members of the committee. varga. is dr. daniel i'm the chief clinical officer executive vice for texas health resources. i am truly sorry that i could not be with you in person today and i deeply appreciate the committee's understanding of our situation and how important it is for me to be here in dallas

challenging and time.ive texas health presbyterian hospital is one of 13 wholly owned acute care hospitals in the texas health resources system. we are an 898-bed hospital, treating some of the most complicated cases in north texas. texas health dallas is magnate facility by the american nurses credentialing center. texas health resources is one of faith-based centers not-for-profit health systems in the u.s. and the largest in north texas in terms of patients served. our mission is to improve the people in the communities we serve. and we care for all patients regardless of their ability to pay. we serve diverse communities and as such, we provide one standard all, regardless of race or country of origin.

as the first hospital in the country to both diagnose and treat a patient with ebola, we committed to using our experience to help other hospitals and health care providers protect public health against this insidious virus. is hard for me to put into words how we felt when our duncan, thomas eric lost his struggle with ebola on october 8. it was davey stating to the nurses -- devastating to the nurses, doctors and team who tried so hard to save his life. his family in our thoughts and prayers. unfortunately, in our initial of mr. duncan, despite our best intentions, and a team, weilled medical made mistakes. we did not correctly diagnose his symptoms as those of ebola are deeply sorry. also, in our effort to the public to quickly and transparently, we inadvertently provided that was inaccurate and had to be corrected. no doubt, that was unsettling to

community that was already concerned and confused, and we have learned from that experience as well. last weekend, nurse nina pham, a of our hospital family, who courageously cared for mr. duncan, was also diagnosed ebola. our team is doing everything possible to help her win that fight. and on tuesday, her condition upgraded to good, and as the nina'smentioned earlier, care continues to evolve. i can tell you that the prayers of the entire texas health with her. yesterday, as has been noted, we identified a second caregiver with ebola. i can also tell you that our and prayers remain with amber as well. a lot is being said about what may or may not have occurred to cause nina and amber to contract ebola. we know that they are both extremely skilled nurses, who

full protective measures under the cdc protocols, so we don't yet know precisely how or when they were infected. but it's clear there was an exposure somewhere sometime and we are poring over records and observations and doing all we answers.nd the you have asked about the on july 28 an infection prevention nurse specialist at texas health received the first centers for disease control and prevention health advisory about ebola virus disease. and began sharing it with other texas health personnel. the health care